Neurological emergencies (such as cerebrovascular accidents) are extremely frequent pathologies both in the Mexican population and in the world. In fact, it is estimated that up to 15% of medical emergencies are of this type, with cerebral infarction, headaches and epilepsy being the most common alterations.
However, these conditions can be difficult to diagnose, and delays in recognition and treatment can have devastating results, with high rates of long-term disability and even death, as reported at the Interinstitutional Congress of Intensive Care “ Quality and safety in the impact of nursing in critical care”.
This event was organized by the Mexican Association of Nurses Specialized in Critical Medicine and Intensive Care (AMEEMCTI), where Dr. Daniel Sánchez Arreola, president of the Mexican Society of Emergency Medicine (SMME), participated with the presentation “Neurological assessment scales in emergencies”.
“When a person is suffering from a neurological emergency, time is of the essence. This is because for every minute that passes without the person receiving treatment, millions of neurons die in his brain, which complicates the chances of a successful recovery, ”he explained.
Therefore, it is recommended that people with neurological emergencies receive prehospital care while awaiting neurological consultation. Following this same line, the care of patients with acute neurological pathologies in health establishments constitutes a latent concern.
According to what was said by Dr. Luis Daniel Sánchez Arreola, president of the SMME, “immediate, timely and effective care depends not only on the survival of the patient, but also on his recovery with the least possible degree of sequelae.”
Thus, hospital emergency services are of vital importance for the initial care of critical patients. However, care is often hampered by the saturation of services, long waiting times and the lack of specialized personnel.
Specifically, it is estimated that delays in emergency services increase up to 1.6 times the chances that the person will die or that their hospital stay will be longer. Hence the importance of improving the care processes of emergency services, because through them hospital costs can be reduced and the patient’s health and quality of life can be improved.
There are several aspects that doctors must assess for the detection of the pathology even before the relevant specialized tests or studies, which will allow decisions regarding treatment to be made.
For example, depending on the incident, an assessment of the person’s mental state should be made, taking into account their level of consciousness and orientation; an assessment of speech and language, motor function, sensitivity and coordination, as well as a pupil examination.
In this sense, the use of an adequate medical triage (a method that allows organizing the care of people according to the existing resources and the needs of the individuals by level of urgency of care), a system of rapid evaluation, transmission and strategic location of medical staff in the emergency department improves patient flow. That is, it can be improved by implementing new work patterns, new technologies, and effective management strategies.
The complexity of neurological diseases, their diagnoses and their treatments, as well as a narrow therapeutic window in prevalent pathologies such as cerebral infarction, make urgent neurological care a fundamental aspect for the efficiency of treatments.
